Abscess Care

This is not intended to replace the diagnosis and/or instruction of your veterinarian. If you find an abnormality, take your chameleon to a herp vet for an exam. This is less a tutorial and more a preview of what it will look like when taking your own vet's recommendation to clean an abscess. Not every vet recommends the same method, some use saline instead of dilute Nolvasan solution, some pack with medication, some open the interior wall to get blood flow (not in this case). The whole process, when the chameleon is calm and restrained, takes mere seconds. This example may prepare you to minimize the time your chameleon is restrained or stressed, thus speeding its healing.

How do abscesses occur? Occasionally, chameleons injure themselves on branches, an insect bites the skin, or a mate's claw pricks the skin. If infection sets in, an abscess is formed when the infection remains but the outer skin breach heals to closed. The healthy chameleon will wall off the infection from the inside, and the abscess will swell and work its way outwards towards an exit (stretched open skin pores, claw bed, nostril, etc). An abscess that does not evacuate on the exterior of the body may remain indefinitely, but there may be risk of the active infection spreading to other parts of the body. In some cases, it may be a sterile abscess, the microbes died and it's just "there" being an unsightly lump. An abscess should always be examined and aspirated by your vet, to determine if any live bacteria or fungi are present (via a Culture and Sensitivity report). Expect to clean out an abscess until the pocket grows fresh, healthy tissue from the inside out. Do not allow the outer skin to heal closed beforehand. This may take weeks or months.

When the chameleon is restrained as shown, it assumes the roosting state. Its colors go from stress spotty to roosting color, it doesn't resist, it basically acts as if it is in a dark shipping box. The easiest way to achieve this is to place it in a dark room, wait for it to relax, and wrap it before turning all lights back on for the procedure. Do not tightly wrap a chameleon, it needs to breathe and feel that it is not being compressed. The entire bundle should feel like feather down in a paper pillowcase, airy and very soft. The innermost paper towel is dampened to keep the chameleon breathing humid air (and keep its skin comfortable). Very large melleri have to be restrained in cotton terry bath towels, preferably one kept just for the animal's use.

Materials shown:

15-20 cotton swabs, cut in halves at an angle with sterile shears (make sharp pointed probes out of the "stems" of the swabs)
3 small gauge sterile syringes (3/10 cc), 2 with needles removed
paper towels
polyfiber quilt batting
paper tape (medical or painter's, low tack)
sterile saline solution or Nolvasan dilute solution, room temp or lukewarm (ideally, the lizard's temperature)
antifungal or antiseptic ointment to pack wound, ie, Silvadene cream

Gather your equipment and clean a surface with alcohol or Nolvasan.

Prepare the packing medication (Silvadene is shown here) by drawing it into a sterile syringe that had its needle removed.

The cause of this chameleon's abscess is unknown. The dark spot on the abscess is the scab from the vet's aspirate.

Place cham in a darkened room, perched on top of a damp, clean paper towel. Wait for it to settle. Wrap towel around it loosely.

Gather polyfil quilt batting around toweled chameleon.

Wrap the bundle with dry paper towels, and secure lightly (no pressure) with medical paper tape or painter's low-tack tape (shown).If the abscess is on a limb, allow the foot of the limb to grasp some towel. Grip means security to the chameleon.

Swab outer surface of abscess with sterile saline or Nolvasan dilute solution.

Use the needle syringe to cut the skin carefully between the scales, in the dark, smooth "interstitial" skin (this will minimize scarring).

Use a swab probe end to ease some abscess pus or caseous (cheese-like) material out through the incision.

Use a fresh probe as each one becomes soiled. Gently press from the back of the abscess forward to the incision, oozing the material out.

Between probes, swab the area clean of blood and pus with the solution.

Continue steps above until you can see the clean pocket inside the foot, no further pus or caseous material comes out on the probes (probe under edges).

Rinse several times with solution squirted out of a syringe (no needle).

With the no-needle syringe that was loaded with packing ointment, place the tip inside the empty pocket and fill to overflowing with Silvadene.

With a clean swab end, very lightly smear the ointment around the incision area (do not apply pressure, or the medicine will squirt out). Your vet may suggest daily or every other day cleaning of an abscess. I cleaned this one every other day, and on the fourth cleaning, the back end of the abscess was opened to the surface. Those readers with horse experience may know that a toe abscess, such as one around a stone or other foreign body, will often work its way to the coronet or cuticle. In this chameleon's foot, the abscess worked its way down the toe to the claw or nail bed (cuticle) and was slowly being squeezed out of the body. The rinsings and Silvadene applications softened the toe bed plug enough to manually pull it out, clear of the claw. The material is thick, waxy, and leaves a clean hole without bleeding, shown here. This removal gave the abscess a natural drain. The rinsings now are squirted out the hole around the healthy claw. The packing medication is loaded in the hollow until it overflows out around the claw bed and the original surgical opening above the toe. The healed toe abscess. Only a scar remains after one shed.